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Sadaghiani MS, Baskaran S, Gorin MA, Rowe SP, Provost JC, Teslenko I, Bilyk R, An H, Sheikhbahaei S. Utility of PSMA PET/CT in Staging and Restaging of Renal Cell Carcinoma: A Systematic Review and Metaanalysis. J Nucl Med 2024:jnumed.124.267417. [PMID: 38782453 DOI: 10.2967/jnumed.124.267417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Prostate-specific membrane antigen (PSMA) is expressed in the neovasculature of multiple solid tumors, including renal cell carcinoma (RCC). Studies have demonstrated promising results on the utility of PSMA-targeted PET/CT imaging in RCC. This report aims to provide a systematic review and metaanalysis on the utility and detection rate of PSMA PET/CT imaging in staging or evaluation of primary RCC and restaging of metastatic or recurrent RCC. Methods: Searches were performed in PubMed, Embase, and abstract proceedings (last updated, August 2023). Studies that provided a lesion-level detection rate of PSMA radiotracers in staging or restaging of RCC were included in the metaanalysis. The overall pooled detection rate with a 95% CI was estimated, and subgroup analysis was performed when feasible. Results: Nine studies comprising 152 patients (133 clear cell RCC [ccRCC], 19 other RCC subtypes) were included in the metaanalysis. The pooled detection rate of PSMA PET/CT in evaluation of primary or metastatic RCC was estimated to be 0.83 (95% CI, 0.67-0.92). Subgroup analysis showed a pooled PSMA detection rate of 0.74 (95% CI, 0.57-0.86) in staging or evaluation of primary RCC lesions and 0.87 (95% CI, 0.73-0.95) in restaging of metastatic or recurrent RCC. Analysis based on the type of radiotracer showed a pooled detection rate of 0.85 (95% CI, 0.62-0.95) for 68Ga-based PSMA tracers and 0.92 (95% CI, 0.76-0.97) for 18F-DCFPyL PET/CT. Furthermore, in metastatic ccRCC, the available data support a significantly higher detection rate for 18F-DCFPyL PET/CT than for conventional imaging modalities (2 studies). Conclusion: Our preliminary results show that PSMA PET/CT could be a promising alternative imaging modality for evaluating RCC, particularly metastatic ccRCC. Large prospective studies are warranted to confirm clinical utility in the staging and restaging of RCC.
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Affiliation(s)
- Moe S Sadaghiani
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Michael A Gorin
- Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York; and
| | - Steven P Rowe
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | | | | | - Hong An
- Lantheus, Bedford, Massachusetts
| | - Sara Sheikhbahaei
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland;
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2
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Tariq A, Pearce A, Rhee H, Kyle S, Raveenthiran S, Pelecanos A, Gan CL, Goh JC, Wong D, McBean R, Marsh P, Goodman S, Dunglison N, Esler R, Navaratnam A, Yaxley JW, Thomas P, Pattison DA, Roberts MJ. The Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Primary Staging of Selected Renal Tumours: Initial Experience in a Multicentre Cohort. Eur Urol Focus 2024:S2405-4569(23)00296-1. [PMID: 38195354 DOI: 10.1016/j.euf.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/02/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Accurate primary staging of renal cancer with conventional imaging is challenging. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) may serve to improve the accuracy of renal cancer staging. OBJECTIVE To determine clinicopathological and management differences for primary renal cancer staged with PSMA PET/CT in comparison to conventional imaging. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective cohort study of PSMA PET/CT scans performed for primary staging of renal cancer and incidental renal lesions at three sites in Brisbane, Australia between June 2015 and June 2020. Clinical characteristics, imaging, and histopathology were reviewed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Clinicopathological and management differences according to staging modality (PSMA PET/CT, conventional imaging) were assessed. Descriptive statistics were used to report demographics and clinical parameters. Nonparametric methods were used for statistical analysis. Fisher's exact test was used for comparison of small-cell size categorical variables. RESULTS AND LIMITATIONS From a total of 120 PSMA PET/CT scans, 61 were included (52 staging, 9 incidental) for predominantly males (74%) with a mean age of 65.1 yr (standard deviation 12.0). Most primary lesions (40/51) were clear-cell renal cell carcinoma (ccRCC; 98% PSMA-avid), eight were non-ccRCC (75% PSMA-avid), and three were non-RCC (oncocytoma; 67% PSMA-avid). PSMA PET identified a greater number of presumed metastatic lesions than conventional imaging (195 vs 160). A management change was observed for 32% of patients (20% major, 12% minor). Limitations include the retrospective design and selection bias, lack of blinding to PSMA reporting, and the use of different PSMA radiotracers. CONCLUSIONS PSMA PET/CT detected more metastases than conventional imaging and most renal cancers were PSMA-avid, resulting in a management change for one-third of the patients. PATIENT SUMMARY We looked at a newer type of scan called PSMA PET/CT for first staging of kidney cancer. We found that this detects more metastasis and helps in decisions on changes in treatment for some patients. This type of imaging is a useful addition to conventional scans in tricky cases and may help in better selection of suitable treatments, but more studies are required.
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Affiliation(s)
- Arsalan Tariq
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Adam Pearce
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia; Wesley Urology Clinic, The Wesley Hospital, Brisbane, Australia
| | - Handoo Rhee
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
| | - Samuel Kyle
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Australia; Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Sheliyan Raveenthiran
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Department of Urology, Redcliffe Hospital, Redcliffe, Australia
| | - Anita Pelecanos
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Chun Loo Gan
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Jeffrey C Goh
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - David Wong
- Department of Radiology & Nuclear Medicine, The Wesley Hospital, Brisbane, Australia
| | - Rhiannon McBean
- Department of Radiology & Nuclear Medicine, The Wesley Hospital, Brisbane, Australia
| | - Phillip Marsh
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Steven Goodman
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Nigel Dunglison
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Rachel Esler
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Wesley Urology Clinic, The Wesley Hospital, Brisbane, Australia
| | - Anojan Navaratnam
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - John W Yaxley
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia; Wesley Urology Clinic, The Wesley Hospital, Brisbane, Australia
| | - Paul Thomas
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - David A Pattison
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Matthew J Roberts
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia; Department of Urology, Redcliffe Hospital, Redcliffe, Australia; UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia.
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3
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Pathmanathan S, Tariq A, Pearce A, Rhee H, Kyle S, Raveenthiran S, Wong D, McBean R, Marsh P, Goodman S, Dhiantravan N, Esler R, Dunglison N, Navaratnam A, Yaxley J, Thomas P, Pattison DA, Goh JC, Gan CL, Roberts MJ. Clinical impact of Prostate-Specific Membrane Antigen Positron Emission Tomography (PET) on intensification or deintensification of advanced renal cell carcinoma management. Eur J Nucl Med Mol Imaging 2023; 51:295-303. [PMID: 37592084 PMCID: PMC10684606 DOI: 10.1007/s00259-023-06380-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE There is an emerging role of the use of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) in renal cell carcinoma. Herein, we report our experience in use of PSMA PET in recurrent or metastatic renal cell carcinoma (RCC). METHODS A retrospective analysis of all patients who underwent PSMA PET for suspected recurrent or de-novo metastatic RCC between 2015 and 2020 at three institutions was performed. The primary outcome was change in management (intensification or de-intensification) following PSMA PET scan. Secondary outcomes included histopathological correlation of PSMA avid sites, comparison of sites of disease on PSMA PET to diagnostic CT and time to systemic treatment. RESULTS
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Affiliation(s)
- Shivanshan Pathmanathan
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Arsalan Tariq
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Adam Pearce
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Wesley Urology Clinic, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Handoo Rhee
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Samuel Kyle
- Department of, Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Sheliyan Raveenthiran
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Department of Urology, Redcliffe Hospital, Brisbane, Queensland, Australia
| | - David Wong
- I-MED Radiology, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Rhiannon McBean
- I-MED Radiology, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Phillip Marsh
- Department of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Steven Goodman
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Nattakorn Dhiantravan
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Rachel Esler
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Wesley Urology Clinic, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Nigel Dunglison
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Anojan Navaratnam
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - John Yaxley
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Wesley Urology Clinic, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Paul Thomas
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - David A Pattison
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jeffrey C Goh
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Chun Loo Gan
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Matthew J Roberts
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia.
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
- Department of Urology, Redcliffe Hospital, Brisbane, Queensland, Australia.
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.
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4
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Seymen H, Esen B, Kulac I, Aksoy M, Kabaoglu ZU, Demirkol MO, Kordan Y. [ 68Ga]Ga-PSMA-11 and [ 18F]FDG uptake of venous tumor thrombus in inferior vena cava and left common iliac vein from prostate cancer on positron emission tomography. Eur J Nucl Med Mol Imaging 2023; 50:2222-2223. [PMID: 36627497 DOI: 10.1007/s00259-022-06090-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Hulya Seymen
- School of Medicine, Department of Nuclear Medicine, Koç University, Istanbul, Turkey
| | - Baris Esen
- School of Medicine, Department of Urology, Koç University, Istanbul, 34010, Turkey.
| | - Ibrahim Kulac
- School of Medicine, Department of Pathology, Koç University, Istanbul, Turkey
| | - Murat Aksoy
- School of Medicine, Department of Vascular Surgery, Koç University, Istanbul, Turkey
| | | | - Mehmet Onur Demirkol
- School of Medicine, Department of Nuclear Medicine, Koç University, Istanbul, Turkey
| | - Yakup Kordan
- School of Medicine, Department of Urology, Koç University, Istanbul, 34010, Turkey
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Alam AS, Yashi K, Elkhawaga M. Management of Renal Cell Carcinoma With Intra-atrial Tumour Thrombus: A Case Report. Cureus 2023; 15:e35380. [PMID: 36987480 PMCID: PMC10039968 DOI: 10.7759/cureus.35380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 02/25/2023] Open
Abstract
Renal cell cancer (RCC) is at times associated with intravascular tumour thrombus (TT), which in rare cases can extend to the right atrium. The management of RCC with intravascular tumour thrombus is complex and requires a multidisciplinary approach involving urologists, vascular surgeons, and cardiologists. The pre-operative workup is extensive and includes imaging studies to determine the extent of the tumour thrombus and assess the patient's overall health status. Here, we present a case report detailing the operative and perioperative management of a patient presenting with renal cell cancer and intravascular TT.
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Cimadamore A, Caliò A, Marandino L, Marletta S, Franzese C, Schips L, Amparore D, Bertolo R, Muselaers S, Erdem S, Ingels A, Pavan N, Pecoraro A, Kara Ö, Roussel E, Carbonara U, Campi R, Marchioni M. Hot topics in renal cancer pathology: implications for clinical management. Expert Rev Anticancer Ther 2022; 22:1275-1287. [PMID: 36377655 DOI: 10.1080/14737140.2022.2145952] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The updated European Association of Urology (EAU) Guidelines issued a weak recommendation for adjuvant pembrolizumab for patients with high-risk operable clear cell Renal Cell Carcinoma (ccRCC). High risk of recurrence was defined, as per protocol-criteria, as T2 with nuclear grade 4 or sarcomatoid differentiation, T3 or higher, regional lymph node metastasis, or stage M1 with no evidence of disease. Considering the heterogeneous population included in the recommendation, it has been questioned if adjuvant pembrolizumab may lead to overtreatment of some patients as well as undertreatment of patients with worse prognosis. AREAS COVERED In this review, we discuss the issues related to the assessment of pathological features required to identify those patients harboring a high-risk tumor, highlighting the issue related to interobserver variability and discuss the currently available prognostic scoring systems in ccRCC. EXPERT OPINION PPathologist assessment of prognostic features suffers from interobserver variability which may depend on gross sampling and the pathologist's expertise. The presence of clear cell feature is not sufficient criteria by itself to define ccRCC since clear cell can be also found in other histotypes. Application of molecular biomarkers may be useful tools in the near future to help clinicians identify patients harboring tumors with worse prognosis.
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Affiliation(s)
- Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medical Area, University of UdineUdineItaly
| | - Anna Caliò
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Laura Marandino
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Stefano Marletta
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Carmine Franzese
- Department of Urology, Polytechnic University of Marche, Ancona, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Science, "Ss. Annunziata" Hospital Urology Unit, "G. d'Annunzio" University of Chieti and Pescara, Chieti, Italy
| | - Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Stijn Muselaers
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Selcuk Erdem
- Division of Urologic Oncology, Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alexandre Ingels
- Department of Urology, University Hospital Henri Mondor, Créteil, France
| | - Nicola Pavan
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Angela Pecoraro
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Önder Kara
- Department of Urology, Kocaeli University School of Medicine, Izmit, Turkey
| | - Eduard Roussel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Umberto Carbonara
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Science, "Ss. Annunziata" Hospital Urology Unit, "G. d'Annunzio" University of Chieti and Pescara, Chieti, Italy
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Impact of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in the Management of Oligometastatic Renal Cell Carcinoma. EUR UROL SUPPL 2022; 44:60-68. [PMID: 36185587 PMCID: PMC9520507 DOI: 10.1016/j.euros.2022.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Prostate-specific membrane antigen (PSMA) is overexpressed in the neovasculature of renal cell carcinoma (RCC). However, there remains limited evidence regarding the use of PSMA positron emission tomography/computed tomography (PET/CT) in RCC. Objective To assess the impact of PSMA PET/CT in the management of metastatic RCC. Design, setting, and participants This was a retrospective review of patients who underwent PSMA PET/CT from 2014 to 2020 for restaging or suspected metastatic RCC in a tertiary academic setting. Outcome measurements and statistical analysis Management plans before and after PSMA PET/CT were recorded. Impact was classified as high (change of treatment intent, modality, or site), medium (change in treatment method), or low. Secondary outcomes included the patient-level detection rate, PSMA PET/CT parameters, sensitivity, and comparison to CT and, if available, fluorodeoxyglucose (FDG) PET/CT. Results and limitations Sixty-one patients met the inclusion criteria, of whom 54 (89%) had clear cell RCC. PSMA-positive disease was detected in 51 patients (84%). For 30 patients (49%) there was a change in management due to PSMA PET/CT (high impact, 29 patients, 48%). In 15 patients (25%), more metastases were detected on PSMA PET/CT than on CT. The sensitivity of combined PSMA PET/CT and diagnostic CT was 91% (95% confidence interval 77–98%). In a subcohort of 40 patients, the detection rate was 88% for PSMA and 75% for FDG PET/CT (p = 0.17). The maximum standardised uptake value (SUVmax) was higher for PSMA than for FDG PET/CT (15.2 vs 8.0; p = 0.02). Limitations include selection bias due to the retrospective design, and a lack of corresponding histopathology for all patients. Conclusions PSMA PET/CT is a promising imaging modality in metastatic RCC and led to a change in management in 49% of patients. PSMA PET/CT detected additional metastases compared to CT in 25% of patients and registered a significantly higher SUVmax than FDG PET/CT. Prospective studies are required to further define its role. Patient summary We report on a group of patients undergoing a new type of imaging for suspected advanced kidney cancer, called PSMA PET/CT. This imaging changed the management plan in 49% of the patients. PSMA PET/CT detected metastases in 84% of our patients and detected more metastases than computed tomography imaging in 25%.
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Ma J, Zhang Y, Zhou C, Duan S, Gao Y. Tumor thrombus formation in the right common iliac vein after radical proctectomy in a patient with rectal cancer: a case report. BMC Surg 2022; 22:326. [PMID: 36038866 PMCID: PMC9422148 DOI: 10.1186/s12893-022-01768-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background Intravascular tumor thrombi are mainly found in patients with liver cancer or renal carcinoma but rarely occur in those with rectal cancer. Case presentation This is a case report of a 58-year-old woman with a swollen right lower extremity 14 months after radical resection for rectal cancer. Although ultrasonography indicated the presence of deep venous thrombosis (DVT) located in the right common iliac vein, interventional angiography showed that a circular mass, considered a tumor thrombus, was located in the right common iliac vein. The tumor thrombus was cured by interventional therapy, and the pathological report confirmed that the metastatic tumor thrombus originated from the rectal cancer. The patient underwent concurrent chemoradiotherapy and systemic therapy. However, right lung, retroperitoneum, and 2nd sacral vertebral metastases were discovered during follow-up. Conclusion The correct diagnosis of a tumor thrombus and its differentiation from DVT can prevent incorrect treatment and prolong the survival of patients with rectal cancer.
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Affiliation(s)
- Jun Ma
- Department of Surgical Oncology, Anqing Municipal Hospital, No. 352, Ren-Ming Road, Anqing, 246000, Anhui, People's Republic of China
| | - Yaming Zhang
- Department of Surgical Oncology, Anqing Municipal Hospital, No. 352, Ren-Ming Road, Anqing, 246000, Anhui, People's Republic of China.
| | - Chaoping Zhou
- Department of Surgical Oncology, Anqing Municipal Hospital, No. 352, Ren-Ming Road, Anqing, 246000, Anhui, People's Republic of China
| | - Shuqiang Duan
- Department of Pathology, Anqing Municipal Hospital, Anqing, 246000, People's Republic of China
| | - Yan Gao
- Department of Anqing Oncology, Municipal Hospital, Anqing, 246000, People's Republic of China
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